A 34-Year-Old Man Comes to the Emergency Department Due to Severe

question 338

Multiple Choice

A 34-year-old man comes to the emergency department due to severe headache.  The patient describes unbearable, throbbing pain around his right eye that awakened him.  Over the past week, he has had several similar episodes, which spontaneously resolved after 20-30 minutes.  He has no other medical conditions and takes no medications.  The patient smokes a pack of cigarettes daily and drinks alcohol on social occasions.  On physical examination, he appears restless and paces in the room.  There is mild conjunctival injection and miosis of the right eye.  Neurologic examination shows no abnormalities.  Which of the following is the most likely cause of this patient's current symptoms?

• A)Cavernous sinus thrombosis
• B)Cluster headache
• C)Migraine without aura
• D)Opiate withdrawal
• E)Trigeminal neuralgia
• F)Vertebrobasilar ischemia

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Definitions:

Scabies

A contagious skin infestation caused by a tiny mite Sarcoptes scabiei, characterized by intense itching and a pimple-like rash.

Oxygenated Blood

Blood that has been enriched with oxygen in the lungs and is then transported to the body's tissues.

Adipose Tissue

Body tissue that stores fat, providing energy storage and insulation.

Hypodermis

Also known as the subcutaneous layer, this is the deepest layer of skin, composed mainly of fat and connective tissue, providing insulation and cushioning.